Can Children Know, At Age 2, They Were Born The 'Wrong Sex'?

Kathryn's Dad thought she was going through a tomboy phase. Kathryn's Mom suspected it might be something more. From the age of two onwards, Kathryn herself was utterly certain: "I am a boy," the child insisted.

Kathryn's story was told on the front page of The Washington Post last Sunday, and I found it a gripping tale. It explores Kathryn's sense, expressed consistently through her toddler years, that she is a boy, and her parents' "upheaval" in trying to do the right thing by their child. When Kathryn was four, after seeking professional counseling, the parents decided to let her live as a boy.

Tyler (the pseudonym chosen by the Post for Kathryn's new name) now dresses as a boy and attends preschool as a boy. Is Tyler a transgender child, with a natal sex (female) that does not match his gender identity (male)? Can children so young really know their own gender identity? How can families best support these children?

In a course I teach at William and Mary, Evolutionary Perspectives on Gender, my students and I grapple with questions of this nature. One of our primary texts is Sexing the Body by Anne Fausto-Sterling, a biologist and gender-studies expert at Brown University. Three days ago, I spoke with Fausto-Sterling by telephone about some of these issues.

Fausto-Sterling takes a dynamic systems approach to gender identity, one where a number of influences work together as a system to affect a child's experience of gender. She is interested in what happens as the child begins, especially in the second year of life, to move more fully into symbolic thinking, as expressed through verbal language and symbolic play.

"It seems likely that this transition from presymbolic to symbolic and to increasingly internalized representations of gender, which must start in the vicinity of one year of age and carry on for several years, is an especially important period for understanding the developmental dynamics of gender identity," she writes in a new article in the Journal of Homosexuality.

In other words, in the case of Kathyrn-becoming-Tyler, a host of interactions are shaping and reshaping the child's emerging identity, even as the child participates in shaping and reshaping those interactions as well. Thus, as Fausto-Sterling explains in her article, "gender identity is a pattern in time. In any one individual, it is shaped by the preceding dynamics and becomes the basis of future identity transformations."

This framework does not mesh with the "born that way" school of thought — the view that Kathryn was psychologically male right from birth, but trapped in a female's body.

"What could it possibly mean," Fausto-Sterling asked during our phone conversation, "to say that a child is 'born that way'? Children aren't born with identity."

Furthermore, gender identity may not be fixed throughout life. "I doubt it is a permanent thing at age two," Fausto-Sterling noted.

A second article in the Post cites studies that Fausto-Sterling also described for me, showing that significant percentages (ranging from 43 percent to 80 percent) of kids who switch genders at young ages decide to switch back to their natal sex later on.

Tyler's mother is quoted as saying, "If Tyler wants to be Kathryn again [at some point in the future], that's fine." Here we have a family doing its absolute best for the child in what is a challenging — and unpredictable — situation at both the practical and emotional levels.

I wondered aloud with Fausto-Sterling about the entrenched binary nature of this whole discussion. Is it adequate to think in terms of two genders? Doesn't Fausto-Sterling's own work point to a more fluid continuum which, in line with some other cultures' fluidity, breaks us free of "opposite" genders and a locked-in male versus female choice?

"Whether there is, or could be a continuum, is a different issue from our social options," Fausto-Sterling explained. "We don't have any 'continuous' social options, we have to tell the schools [a male or female gender], and put it on the birth certificate, and the driver's license. In our culture, we are forced into this binary."

Something that worries Fausto-Sterling emerges, at least as I see it, from that binary. She is "extremely concerned about the medical consequences" for kids who decide to transition biologically to another gender. The long-term effects of medical interventions, ranging from early puberty blockers to later hormonal treatments and even to sex reassignment surgery, aren't known. Yet Fausto-Sterling understands that it may be agonizing for a child — for anyone — to live in a body that feels totally alien.

What I take away from Fausto-Sterling is this: young children know what they know about their gender in the moment. They may, or may not, change how they feel about being a boy or a girl as the years go by.

One fixed thing about these children, of course, is that they need what we all need: to be loved for who they are, moment by moment.